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Proposed rule bans transgender discrimination in healthcare

If enacted, regulations would extend ACA protections for certain groups

Sex and gender-identity based discrimination among any health program or activity funded by the Department of Health and Human Services (HHS) would be prohibited under a new proposed rule from the agency, a move hailed by some advocacy groups.

The proposed rule would apply to a wide swath of providers and insurers, including all hospitals that treat Medicare or Medicaid patients and all health plans that offer coverage through the Affordable Care Act's health insurance marketplaces.

"This proposed rule is an important step to strengthen protections for people who have often been subject to discrimination in our healthcare system," HHS Secretary Sylvia Mathews Burwell said in an announcement.

Indeed, many advocates for the transgender community have taken issue with insurers' compliance with the ACA mandate that they cannot discriminate against transgender individuals or those undergoing the gender reassignment process.

HHS' Office for Civil Rights already had been accepting complaints from consumers about discriminatory practices, the announcement notes, but the proposed rule states explicitly that individuals can take legal action if they feel they have been discriminated against because of their gender identity or sex.

"These rules will help finally make the promise of the Affordable Care Act real for transgender people--that they can find affordable health insurance that covers the essential care they need and doesn't exclude care simply because of who they are," National Center for Transgender Equality (NCTE) Executive Director Mara Keisling said in a statement. "NCTE is thrilled that HHS has recognized these exclusions as the discrimination they are, plain and simple."

The Leadership Conference on Civil and Human Rights expressed similar sentiments, adding that it urges the Obama administration "to move promptly after the end of the comment period to finalize the regulations so as to ensure effective implementation of this crucial new civil rights protection."

The proposed rule would specifically prohibit blanket policies from insurers that ban coverage of gender-transition care as well as require individuals to be treated consistent with their gender identities. It also would extend protections to women, prohibiting discrimination on the part of providers. The ACA's current policies prevent insurers from charging women more for coverage.

Finally, the rule provides clearer guidance for providers about the type of assistance they must provide for individuals who speak limited English as well as individuals with disabilities.

To learn more:
- here's the proposed rule (.pdf)
- read the HHS announcement
- check out the NCTE statement
- here's the Leadership Conference statement

Related Articles:
Debate continues whether insurers comply with ACA's transgender-coverage mandate
Feds ban health insurers that have blanket exclusions on gender transition care
More insurers cover gender reassignment surgeries
Transgender patients form their own health referral networks